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CEDAR DENTAL CLINICAL I LLC NPI 1942817960


NPI Information

NPI: 1942817960
Provider Name: CEDAR DENTAL CLINICAL I, LLC
Classification: Dentist - 1223X0400X
Entity Type: Organization

Specialization: Orthodontics and Dentofacial Orthopedics

Address:
4272 WASHINGTON RD STE 7A
EVANS, GA
ZIP 30809
Phone: (706) 621-7586
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CEDAR DENTAL CLINICAL I, LLC is an orthodontics and dentofacial orthopedics dentist in Evans, GA. The provider is that area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. CEDAR DENTAL CLINICAL I, LLC NPI is 1942817960. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4272 WASHINGTON RD STE 7A
EVANS, GA
ZIP 30809-073
Phone: (706) 621-7586
Fax: (706) 621-7586

The provider's authorized official is Henry Rankin Dallam .
The authorized official title is President and has the following contact phone number (770) 331-2529.

The enumeration date for this NPI number is 9/24/2020 and was last updated on 9/24/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223X0400XDentistOrthodontics and Dentofacial OrthopedicsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DNO13071OTHERGEORGIAGA DENTAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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